What is “Ozempic face,” and can you avoid it?

What the term means

It started as a description, not a finding. The authors of the scan study below open their paper with what facial plastic surgeons had been reporting: patients presenting with “facial deflation and a prematurely aged appearance”, described as a reported side effect of semaglutide. The paper also says no objective data yet existed to measure that volume loss.

You won’t find it on the labels. Neither the WEGOVY nor the OZEMPIC prescribing information uses the phrase, and neither lists a change in the face among its side effects — not in WEGOVY’s table of reactions and not in OZEMPIC’s. The one place either mentions the face is “swelling of your face, lips, tongue or throat” as a sign of a serious allergic reaction, which is a different thing entirely.^1,2

What the scan study measured

A team at one academic medical center searched its records for patients who had been prescribed a GLP-1 drug and happened to have a head or neck CT or MRI scan from both before and after the prescription. Twenty did. Their median age was 54, they’d been on the drug for an average of 321 days, and they’d lost an average of 11.0 kg. The researchers measured the volume of the midface on the before and after scans, in total and layer by layer.³

The superficial fat is the layer that followed the scale. The more weight a patient lost, the more superficial volume they lost; the deep layer varied widely and showed no such link. Put as a single number, the authors estimate “a loss of 7% facial volume for every 10 kg of weight lost.”³

It’s a small study, and its authors call it one of the first quantitative looks at the problem. Twenty people at one center, chosen because their scans already existed, is a start rather than a verdict. Every patient in it was on a GLP-1 drug, so it can’t say whether losing the same weight another way would change a face just as much.

The larger study counted procedures

The other study is much bigger and measures something different. Researchers used a large health-records database to follow adults aged 50 to 60 with type 2 diabetes for 10 years, comparing 297,210 people on a GLP-1 drug with 297,210 matched people who weren’t.⁴

The GLP-1 group had eyelid and brow procedures at higher rates. The hazard ratio for upper eyelid surgery was 1.81, for repairing a drooping upper eyelid 1.84, and for repairing a drooping brow 1.87, meaning each happened at a rate roughly 80 to 90% higher over the follow-up. Repair of an in-turned eyelid showed no significant difference.⁴

It’s an association in medical records, not a measurement of anyone’s face. It covers every GLP-1 drug, not only semaglutide, and people with diabetes rather than people taking a drug for weight loss. And it compares users with non-users, not with people who lost the same weight another way, so it can’t tell the drug apart from the weight the drug takes off.

Can you avoid it?

Neither study tested a way to avoid it, and neither label offers one. What the scan study does show is that the superficial loss rose with the kilograms lost, which ties it to how much weight comes off rather than to the brand name on the pen. The two brands are the same molecule, and what separates WEGOVY from OZEMPIC on their labels is what each one is approved to treat.^3,4 That is also why weight regain after stopping should be treated as a separate question from changes in facial appearance.

How fast weight came off in the WEGOVY trials is laid out week by week on its own page. If the way your face is changing bothers you, tell your prescriber.

Questions